Workers’ Compensation: Temporary Disability Benefits

There are two categories of temporary disability benefits: temporary total disability (TTD) and temporary partial disability (TPD, also known as “wage-loss TD”). Both are payments to compensate for lost wages while you are recovering from your injury or illness.

TTD payments are made if you cannot work at all during your recovery.

TPD payments are made if you can return to your work, but only for limited hours or limited duties at a lower wage. You may also be eligible if your doctor restricts the type of work you can do, and your employer does not provide full-time work (she only has part-time work) that fits into your restrictions.

Usually TTD benefits are equal to two-thirds of your prior gross (before tax) income. Your gross income includes overtime and the market value of board, lodging, and fuel. You may also receive more than two-thirds of your wages at the time of your injury if you were scheduled for a pay raise. In that case, you may receive two-thirds of the higher wage.

Usually TPD benefits are equal to two-thirds of your lost wages, subject to your maximum TD rate. Your lost wages are the difference between your average weekly wages and the amount you are earning by working part-time.

Calculate your average weekly wage by adding your wages from all jobs. The rate will be equal to two-thirds of the wages from all jobs combined. Keep in mind that your gross income includes all jobs that are affected by your inability to work based on the advice of your treating doctor.

Usually your treating doctor. If you disagree with your doctor’s evaluation, you may request a change of treating doctor or get a second opinion from a Qualified Medical Examiner (QME) or an Agreed Medical Examiner (AME). Your claims administrator may also disagree with your treating doctor and request a second opinion from a QME or AME.

If there is a delay, your claims administrator must send you a delay letter within fourteen days of your request for benefits explaining the reason for the delay, further information she needs to process your claim, and when you can expect a decision. A decision is usually required within 90 days from the date you reported your claim.

If there is a delay and you do not receive a delay letter within fourteen days of your request, your claims administrator is required to pay an additional 10% even if there was a reasonable excuse for the delay.

Call the insurance company and follow up with a written letter requesting your TD benefits.

Disclaimer

This Fact Sheet is intended to provide accurate, general information regarding legal rights relating to employment in California. Yet because laws and legal procedures are subject to frequent change and differing interpretations, the Legal Aid Society–Employment Law Center cannot ensure the information in this Fact Sheet is current nor be responsible for any use to which it is put. Do not rely on this information without consulting an attorney or the appropriate agency about your rights in your particular situation.